What does Johnson’s new team mean for health?

26 Jul What does Johnson’s new team mean for health?

Summary

Sajid Javid was announced as Chancellor in Boris Johnson’s Cabinet last night. Matt Hancock remains as Health Secretary. Over the course of yesterday, the new Prime Minister also began to reveal who is going to be a part of his wider advisory team at 10 Downing Street.

If you’re a time-poor, but information and insight-hungry person, then we think you’ll find our crib sheet on key figures (not the usual health suspects) and their policy positions helpful. It provides a snapshot analysis of where advice and thinking may steer Johnson’s premiership over the coming months, as he leads what is effectively a new Government with the slimmest of majorities ahead of a potential General Election.

Sajid Javid – Chancellor

• Javid didn’t make any major announcements on social care during the leadership campaign. At the BBC debate for the final five contenders, Javid responded to a question on cuts to health and social care spending by saying that he had ‘relied on public services his whole life’, and: ‘We do need to reset spending in certain areas, and I think local government is one of those…The question is how you are going to fund it.’
• In February 2018, during his time as Local Government Secretary, Javid announced a £150m boost to adult social care services for 2018/19. This is on top of a £900m boost in December 2016, which allowed councils to raise the tax for social care by 6% across two years, in order to raise funds.
• It is a widely expected spending will go up under Johnson and Javid. Javid has previously argued for increased borrowing in order to build new housesand invest in infrastructure, arguing that such borrowing would act as an investment multiplier and empower the economy. As interest rates are at historically low rates, the Government can borrow at lower rates – making increased spending more palatable and less expensive now than in the future. This shows he is not afraid to spend, particularly so if the ramifications of the investment have a positive economic effect down the line.
• Additionally, Javid praised a recent report called ‘Firing on all Cylinders’ from Onward, authored by former MP and SpAd to George Osbourne Neil O’Brien. O’Brien argues for increased spending, including on social care. You can read the full report here. Regarding the report, Javid said: ‘It is only by building a strong, balanced economy, and investing in our public services that we can ensure everyone can have the opportunity to get on in life and do well.’

Dominic Cummings – senior advisor or ‘chief executive’

• Famously the architect of the Brexit £350m pledge and the Vote Leave campaign. Very cognisant of the importance of the NHS to voters, having commissioned numerous research and polling on it during the referendum campaign.
• Wrote an article on his blog in February this year talking about how we should make genomic sequencing free and available to all as the single biggest enabler of preventative health. He is very keen to turn the ‘NHS’ into a scientific powerhouse and sees genomics as the frontier of what can be achieved in terms of large-scale population health interventions.
• In the same article he pushed for the creation of a Data Science Unit in Downing Street – ‘able to plug into the best researchers around the world, and ensure that policy decisions are taken on the basis of rational thinking and good science or, just as important, everybody is aware that they have to make decisions in the absence of this’.
• Has written extensively about the need for a total and wholescale overhaul of the civil service, calling them ‘the blob’ and once said: ‘I have worked in Whitehall and dealt with a decrepit Downing Street and Sir Humphrey at his worst.’

Sir Edward Lister – will serve as the PM’s chief of staff

• Having worked closely with Johnson whilst he was Mayor of London, Lister is expected to head the transition team for anywhere between eight months to a year.
• Nicknamed ‘Steady Eddie’ Lister is widely known for providing a counterpoint to Johnson’s ‘chaos’. As the Leader of Wandsworth Council from 1992-2011, whilst in position he maintained the country’s lowest council tax charges. Working with Johnson as Deputy Mayor for Policy and Planning, Lister was opposed to raising council tax, believing that ‘low tax is important.’ He was not opposed to increases in transport fares, saying ‘charges, by and large, are for things people have a choice about.’
• This attitude would fit with Lister backing a voluntary social care insurance policy model, allowing people to make contributions from their wages, rather than introducing new taxes to fund a more ambitious scheme to fix the crisis. Lister has been formative in working up a domestic policy agenda with Johnson, in which this policy is widely expected to appear.
• The media notes he has ‘considerable background in facilitating large-scale urban regeneration schemes and coordinating major public and private sector partnerships.’ This could indicate a support for increasing the NHS and pharmaceutical’s collaborative efforts to solve some of the ‘stickiest’ of public policy challenges such as cancer and earlier diagnosis. 

Liam Booth-Smith – will serve as deputy chief of staff (one of three) with responsibility for policy

• Previously served as a SpAd in Housing, Communities and Local Government, chief executive of think tank Localis and in comms roles at the New Local Government Network.
• In 2017 he backed Theresa May’s attempts to make mental health investment and reform her legacy, writing: ‘The government should commit to a programme of mental health services reform, not just the repeal of outdated legislation.’
• Authored a report in 2017 on ‘Rebooting Health and Social Care Integration’. In this he wrote the social care green paper should make the question of a sustainable funding solution central, and the Government should re-commit to a capped model and explore funding options such as hypothecated taxes.
• Fascinatingly, in an article for Prospect magazine in 2016, Booth-Smith argues for greater devolution of power in the delivery of healthcare services, saying ‘the government should explore the creation of specific local health taxes. If the local NHS and council have a strong case to raise funds in order to tackle an important local health priority, they should be allowed to institute it.’